Emergency oxygen therapy: from guideline to implementation

Abstract

<h3>Educational aims</h3> To help readers understand the best way to use oxygen when they care for patients with medical emergencies. To encourage best practice in the use of emergency oxygen therapy. To raise awareness of the British Thoracic Society (BTS) guideline for emergency oxygen use. <h3>Summary</h3> Oxygen is the most commonly used drug in emergency medicine and when used judiciously in the treatment of hypoxaemia it undoubtedly saves life. However, oxygen is often used inappropriately and the dangers of over-oxygenation are unappreciated. In 2008, the first formal guidance on emergency oxygen use was produced by the British Thoracic Society. The guideline is objective, evidence based and peer reviewed, advocating safe use of oxygen by encouraging target saturation levels to be prescribed for each patient, based on a combination of what is believed to be safe and normal or near-normal. In the majority of patients a target saturation range of 94–98% is advised. The importance of recognition of patients at risk of type 2 respiratory failure is highlighted and, in such patients, a target saturation range of 88–92% is recommended.